A report on maternal health puts India at the 137th spot out of 178 countries. It is appalling the amount of money women pay as bribe for such substandard maternal care.
In Uttar Pradesh, for basic medical care which is supposed to be free, pregnant women and their families pay thousands as bribe.
Families spend money for every step of maternal care, from ambulance driver, examinations to medical supplies and blood transfusion. Services like pre-natal checkups, child birth and post-natal services are supposed to be free in public, government-funded hospitals.
Women from low-income group are more likely to use government facilities, but they pay bribes because they are afraid they won't be taken care of by the hospital staff. Health care providers with certain amount of power demand money from the poorest women and their families, expectant mothers trust them with taking care of their health during an emotionally and physically hard time. But the maternal care received is substandard and negligent.
Women are even told they won't see their baby again unless a bribe is paid. The cost is more for a newborn boy than a girl. Women in the rural areas of India, with limited resources and low-income communities suffer from lack of adequate health resources that the government is supposed to provide for free.
The Indian government started National Rural Health Mission in 2013 to provide villages in India a community health worker called an Accredited Social Health Activist (ASHA). A female activist within the community is trained to serve as a liaison between community and the health system. Women report that the activists demand for bribes for medical care that are not in the best interest of the patient.
ASHAs are given incentives to promote sterilizations, for example, as they get paid for each woman who undergoes sterilization in their care.
Mera Swasthya, Meri Aawaz Mera (My Health, My Voice) started by Uttar Pradesh-based NGO, SAHAYOG, promotes gender equality and women health as human right. The initiative supports women and community members taking an active role in reporting illegal fees charged for free medical services.
A collective and community-based push towards policy change is necessary, in a system where women from low-income group pay bribe for free, basic services and still receive substandard maternal care.